What you need to know about lower back pain? Part 2

Where is my lower back pain coming from?

Now we have answered some common myths, lets look at the structure of the spine and where your lower back pain might be coming from.

Bones and Joints

The spinal column is made up of bones, called vertebrae, which are stacked on each other in a natural S-curve from your neck to your tailbone. On the sides of your vertebrae are bony protrusions called processes that can be felt all the way down your back and are anchor points for muscles and ligaments, which provide support to the spine. Between each vertebrae are discs, little gel spheres that cushion the bones of the vertebrae so they don’t rub together. Lastly, the joints of the spine are found behind the discs. These are called facet joints and determine how much we can bend, twist and turn.

What can cause pain here?

  • FRACTURE: Like any bone, your vertebrae can fracture, and usually results from high-energy trauma such as a car crash or sports accident, or a pre-existing condition like osteoporosis where bones are weaker than normal.
  • DISC HERNIATION: The bones of your lower back near your pelvis bear the most weight and move more than the other sections of your spine. This makes them more prone to disc herniation or degeneration leading to lower back pain that may radiate down your legs.
  • FACET JOINT PAIN: The joints behind the discs can become stiff, hypermobile, or locked causing pain and changing your normal range of motion.

Nerves

The spine protects the spinal cord, which runs from the brain down the spine. The spinal cord itself, consists of millions of nerve fibres which carry information to and from the limbs, trunk and organs of the body, back to and from the brain. There are 31 pairs of spinal nerves, which branch off and exit at each spinal level. These nerves sense pain, control movement and function of organs.

What can cause pain here?

  • NERVE DAMAGE: If spinal nerves are damaged, or pinched, sufferers may experience back pain that radiates down the leg or into the foot as a result of irritation.

Muscles

The muscles of the back include the spinal erectors, quadratus lumborum, rhomboids, the lats, the traps and many others closer to the spine itself. In addition to supporting the spine, these muscles are involved in many other movements, such as bending or twisting.

What can cause pain here?

  • STRAIN: The single most common cause of lower back pain is a strained muscle, which occurs when a muscle is stretched too far. This can happen from lifting a heavy object, twisting under load, poor posture, or sports injuries.
  • OTHER STRUCTURES: It’s also important to consider other muscles around the pelvis and hips including the psoas, iliacus, hamstring, glutes and quadriceps. These muscles have attachment points within the abdominal or lower back region and can cause pain or dysfunction in the lower back.

Connective tissues

Ligaments, joint capsules and fascia make up the connective tissues. Their job is to limit end of range motion, hold bones together, and provide support and protection.

What causes pain here?

  • SPRAIN: These structures can become irritated with repetitive activity or when overstretched resulting in a sprain injury. Usually this pain is local and has a slow onset.

Understanding the structures and associated symptoms listed above may give insight as to what’s causing your lower back pain. However, the treatment plan for each diagnosis will be different, so if you are experiencing ongoing discomfort it’s important to seek help.

In Part 3 of this series, we will explore some easy ways to assess your lower back pain that you can do from the comfort of your own home. To get all our articles delivered straight to your inbox make sure you sign up to the newsletter.

Andrew Ilieff

Andrew Ilieff

Andrew Ilieff is a physiotherapy based in Double Bay, Sydney. Andrew has successfully treated lower back problems on the basis of a thorough assessment and diagnosis coupled with evidence-based rehabilitation programs tailored to the needs and goals of each individual. To book a consultation, click the link below.

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